Objective To evaluate the clinical performance of INNOVANCE D-Dimer,and provide information for clinical application.Methods 402 cases of sodium citrate anticoagulant blood were tested with INNOVANCE assay and PLUS assay on CA7000 analyzer to measure plasma D-Dimer levels.VIDAS-30 immunology analyzer was also used to validate the two assays.4 patients with elevated D-Dimer were monitored continuously during 5 days using INNOVANCE assay and PLUS assay respectively,then the consistency of trend between 2 assays was analyzed.Plasma specimens added with hemoglobin,bilimbin and triglyceride were used to verify the anti-interference capability of INNOVANCE D-Dimer assay.Results In 402 specimens,the result ranges of INNOVANCE D-Dimer and PLUS D-Dimer were [2.15 (0.33,8.63)]mg/L FEU and [325.50 (123.75,974.00)] μ,g/L DDU,respectively.The consistency between two assays was poor (Z =-17.375,P =0.000),especially the results in the range of PLUS D-Dimer (201-300) μg/L DDU and (301-400) μg/L DDU,the coincidence rates were only 25％ and 15％,respectively; the coincidence rate was up to 85％ during PLUS D-Dimer (500-600) μg/L DDU; the coincidence rate was close to 100％ when PLUS D-Dimer over 700 μg/L DDU.Totally 47 of 402 cases were unmatched between two assays.Verified by VIDAS 30,83.0％ (39/47) was false negative for PLUS assay,4.3％ (2/47) was false negative for INNOVANCE assay,12.7％ (6/47) was false positive for PLUS assay.There were 5 false positives and 39 false negative for PLUS assay,totally 45 cases; Two false negative for INNOVANCE assay.Four patients with elevated D-Dimer were monitored and the results showed similar trend between 2 assays.For INNOVANCE assay,the capacity of anti-interference to free bilirubin,unconjugated bilirubin,hemoglobin,and triglyceride was up to 217 μmol/L,337 μmol/L,41.04 g/L,18.35 mmol/L,respectively.Conclusions INNOVANCE assay can markedly reduce false negative results of D-Dimer compared with PLUS assay.INNOVANCE D-Dimer has good performance on anti-interference to jaundice,hemolysis and lipemia samples.

OBJECTIVETo explore clinical effects of suturing-assisted locking plate in treating elderly proximal humeral fractures.

METHODSFrom January 2005 to January 2013, 55 elderly patients with three- and four-part fractures of proximal humeral fractures were divided into treatment group and control group. In treatment group, there were 31 patients including 12 males, and 19 females aged from 65 to 85 with an average of (74.00±5.42) years old, and treated with suturing-assisted locking plates; 19 patients were Neer 3-part fractures, and 12 patients were Neer 4-part fractures of proximal humerus; 23 patients were suffered from low-energy injuries and 8 patients were caused by high-energy injuries. In control group, there were 24 patients including 7 males, and 17 females aged from 65 to 85 with an average of (72.79±5.34) years old, and treated with locking plates; 16 patients were Neer 3-part fractures, and 8 patients were Neer 4-part fractures of proximal humerus; 17 patients were suffered from low-energy injuries and 7 patients were caused by high-energy injuries. Operative time, blood loss during operation, and bone healing time between two groups were observed and compared. Postoperative Neer scoring were used to evaluate recovery of shoulder joint function.

RESULTSAll patients were followed up from 6 to 24 months with an average of 16.1 months. In treatment group, blood loss was (495.806±143.150) ml, function of Neer scoring was 22.645±2.443, range of action was 18.194±2.613, anatomy was 7.935±1.504 and total score of Neer scoring was 77.161±8.335; while in control group, blood loss was (641.667±169.851) ml, function of Neer scoring was 13.958±1.989, range of action was 13.083±2.165, anatomy was 5.500±1.978 and total score of Neer scoring was 58.792±7.313. There were sigificant difference between two groups in these indexes.

CONCLUSIONSuturing-assisted locking plate for the treatment of proximal humerus fractures in elderly, has advantages of less blood loss, simple fracture reduction and rapid recovery of shoulder joint, and is a effective method.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Humans ; Male ; Recovery of Function ; Shoulder Fractures ; physiopathology ; surgery ; Shoulder Joint ; physiopathology ; Sutures

Glutaraldehyde clinically is the most commonly accepted crosslinking reagent for bioprosthetic valves preparation. Glutaraldehyde-treated tissue is stable against chemical and enzymatic degradation; however, its calcification and cytotoxicity are severe. Dye-mediated photooxidation is an alternative tissue preservation method that oxidizes the protein with visible light in the presence of a suitable photosensitizer. This article reviews chemical mechanism, research progress, clinical applications future development of these two methods.
Animals ; Bioprosthesis ; Calcinosis ; Cross-Linking Reagents ; Glutaral ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Photochemistry

OBJECTIVETo crosslink bovine pericardial valves by phthalocyanine sensitized photooxidation reaction.

METHODSFresh bovine pericardial tissues were immersed in PBS solution containing 0.01% cupreous sulfonatophthalocyanine and exposed to a broad wavelength light source for 20-120 h. Using sodium dodecyl sulfate-polyarylamide gel electrophoresis (SDS-PAGE) to analyze the cross-linking extent of pericardial tissue. With the help of attenuated total reflection-fourier transform infrared (ATR-FTIR), explained the change of protein structure after photooxidation reaction. Differential scanning calorimetry (DSC) was used to measure the change of shrinkage temperature. Tissue water content experiment method was also used.

RESULTSPhotooxidized tissue was resistant to extraction when it was compared with untreated tissue and had similar crosslinking extent over glutaraldehyde-treated tissue. The three dimension structure of collagen were changed but not seriously destroyed and the model of photooxidation reaction was validated. Phthalocyanine-treated tissue was much more flexible than glutaraldehyde-treated tissue.

CONCLUSIONBovine pericardial tissue can be successfully crosslinked by phthalocyanine-mediated photooxidation reaction.

Animals ; Bioprosthesis ; Cattle ; Cross-Linking Reagents ; Electrophoresis, Polyacrylamide Gel ; Heart Valve Prosthesis ; Indoles ; Pericardium ; chemistry ; Spectroscopy, Fourier Transform Infrared

OBJECTIVETo introduce a new flap for the repair of soft tissue defects in the hand.

METHODSThe distally pedicled ulnar flap is based on the ascending branch of the upper-wrist cutaneous branch of the ulnar artery. The retrograde flow is ensured by the dorsal carpal arch via the descending branch.

RESULTSFrom 2000 to 2003, the flap was used to treat 8 cases of hand defects, including 3 dorsal defects, 2 palmar defects and 3 the first web defects. All flaps survived and the appearance was satisfactory.

CONCLUSIONSThe reverse forearm flap pedicled with the ulnar branch of the ulnar artery provides a long vascular pedicle. The donor site scar is aesthetically acceptable.

Adult ; Female ; Forearm ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Ulnar Artery ; surgery ; Wrist

OBJECTIVETo explore toxicokinetics of tetramethylene disulphotetramine (TETS) in rabbit and the effects on toxicokinetics of TETS after activated charcoal by gavage.

METHODSEight rabbits were exposed through gavage and vein respectively, the blood samples were collected from the center artery in ear of rabbit at an arranged time. Four rabbits were exposed after being intubated into urethra and common bile duct. The samples of bile and urine were collected at arranged times. After being exposed by gavage, activated charcoal (1 g/kg) was administrated in the activated charcoal group and the distilled water (1 g/kg) administrated to the controls. The samples of blood were collected from the center artery in ear of rabbit at arranged times. The contents of TETS in samples were determined by GC/NPD method. Analysed by the 3p87 soft, toxicokinetics parameters of TETS were acquired.

RESULTSTETS was eliminated very slowly in rabbit. The plasma half time in elimination phase (Tke1/2) of TETS was 56.9 hours in vein exposure group and 262.5 hours in oral exposure group respectively. The plasma clearance (CL) of it was only 15.4 ml.kg(-1).h(-1) in oral exposure group and 24.1 ml.kg(-1).h(-1) in vein exposure group. TETS was eliminated from urine in rabbit. The eliminated amount of it from urine was more 5 times than from bile. All parameters of toxicokinetics of TETS were significantly different between the activated charcoal group and the control. Compared to the control, Tke1/2 of TETS in the activated charcoal group was equal to 55%, CL was increased over 3-fold, area under the curve was equal to 30%.

CONCLUSIONTETS was a poison eliminated very slowly in body. The eliminated amount of it from urine was more than from bile. The excretion of TETS could be quickened after activated charcoal by gavage.

Animals ; Antidotes ; administration & dosage ; Bile ; metabolism ; Bridged-Ring Compounds ; blood ; pharmacokinetics ; urine ; Charcoal ; administration & dosage ; Female ; Male ; Metabolic Clearance Rate ; drug effects ; Rabbits

OBJECTIVETo investigate the diagnosis and treatment of benign duodenal tumor.

METHODSClinical data of 14 patients with benign duodenal tumor confirmed pathologically or by operation from Oct.1988 to Oct.2001 were analyzed retrospectively.

RESULTSOf 14 patients, 5 had Brunner's grand adenoma, 4 mesenchymoma, 2 leiomyoma, 2 hemangioma, 1 lipoma. Upper abdominal discomfort (64% ), gastrointestinal bleeding(50% ) and abdominal pain(20% ) were common manifestations. All cases received gastroscopy and only one case was diagnosed. Five cases received duodenoscope and the diagnosis was confirmed in 4 cases. Nine cases received hypotonic duodenography and lesions were found in 8 cases. Digital subtraction angiography was performed in 3 cases and detected all lesions. Computed tomographic scan and B-ultrasound were performed in 2 cases and only one case was diagnosed. Eleven cases (79% ) got definite diagnosis before operation. Tumor resection was performed in all patients. Perioperative death occurred in one patient. No recurrence occurred in 13 cases after following up from 2 to 11 years.

CONCLUSIONUpper abdominal discomfort and gastrointestinal bleeding are common features in patients with benign duodenal tumor. Duodenoscopy and hypotonic duodenography are good diagnostic approaches. Surgical tumor resection is the first choice of treatment.

Adult ; Aged ; Duodenal Neoplasms ; diagnosis ; pathology ; surgery ; Duodenoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage.

METHODSThe multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately.

RESULTSIn 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both P<0. 05]. Except that NIHSS scale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow-up observation, Barthel index was improved obviously as compared with that before treatment in the patients of the two groups (all P<0. 05). The improvement in the acupuncture group was much more significant as compared with the conventional treatment group [75. 0 (60. 0,87. 5) vs 65. O (36. 3, 87. 5), P<0. 051.

CONCLUSIONBased on the conventional treatment, Acupuncture achieves the satisfactory clinical efficacy on motor dysfunction in ischemic stroke of subacute stage.

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Motor Activity ; Stroke ; physiopathology ; therapy ; Treatment Outcome

Objective To evaluate the predictive value of baseline serum high sensitivity C-reactive protein for the first cardio-cerebral vascular event in the population with diabetes. Method In this prospective cohort study, a total of 101 510 employees of Kai Luan Group, who received healthy examination from July 2006 to October 2007, were screened and 7865 subjects with fasting plasma glucose ≥ 7. 0 mmol/L or known diabetes mellitus and under insulin or hypoglycemic drugs therapy were followed up for 38 - 53 (48. 02 ± 3. 14) months. Results ( 1 ) Incidence rates of total cardio-cerebral vascular events, cerebral infarction and myocardial infarction increased in proportion to increased levels of baseline hsCRP ( P ＜ 0. 01 ). After adjusting for age, gender, body mass index ( BMI), systolic blood pressure( SBP), diastolic blood pressure (DBP), total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and cigarette smoking, multivariate Cox's proportional hazards regression analysis indicated that the individuals in the highest quartile of hsCRP levels group (hsCRP≥2. 50 mg/L) had an increased risk of total cardio-cerebral vascular events (RR: 1.64, 95% CI:1.20-2.24), cerebral infarction (RR: 1.52, 95% CI: 1.03-2.24), myocardial infarction (RR: 2.57,95% CI: 1.34 -4. 91 ) compared with those in the lowest quartile group( hsCRP ＜ 0. 41 mg/L). (2) Higher baseline hsCRP levels were associated with aging, female gender, higher BMI, SBP, DBP, fasting blood glucose, TC, TG, LDL-C levels and lower HDL-C levels ( all P ＜ 0. 05 ). Conclusion Baseline hsCRP level is associated with increased first cardio-cerebral vascular event in the population with diabetes.

BACKGROUNDThe infarct size determines the long-term prognosis of patients with acute myocardial infarction (AMI). There is a growing interest in repairing scar area by transplanting bone marrow stem cells. However, effectiveness of intracoronary injection of bone marrow mesenchymal stem cells (BMSCs) in patients with AMI still remains unclear.

METHODSSixty-nine patients with AMI after percutaneous coronary intervention (PCI) were randomly divided into intracoronary injection of BMSCs (n = 34) and saline (control group, n = 35) groups. Serial single positron emission computer tomography (SPECT), cardiac echo and cardiac electromechanical mapping were done at the designed time intervals until six months after transplantation of BMSCs or injection of saline.

RESULTSThe proportion with functional defect decreased significantly in the BMSCs patients after three months [(13 +/- 5)%] compared with that pre-transplantation [(32 +/- 11)%] and the control group [(28 +/- 10)%] at three month follow-up (P < 0.05, respectively). Wall movement velocity over the infracted region increased significantly in the BMSCs group [(4.2 +/- 2.5) cm/s vs (2.2 +/- 1.3) cm/s, P < 0.05], but not in the control group [(2.2 +/- 1.5) cm/s vs (2.7 +/- 1.7) cm/s, P > 0.05]. Left ventricular ejection fraction (LVEF) three months after transplantation in BMSCs group increased significantly compared with that pre-implantation and with that of the control group at three months post-injection [(67 +/- 11)% vs (49 +/- 9)% and (53 +/- 8)%, P < 0.05 respectively]. SPECT scan results showed that perfusion defect was improved significantly in BMSCs group at three-month follow-up compared with that in the control group [(134 +/- 66) cm(2) vs (185 +/- 87) cm(2), P < 0.01]. At the same time, left ventricular end-diastolic volume [(136 +/- 31) ml vs (162 +/- 27) ml, P < 0.05] and end-systolic volume [(63 +/- 20) ml vs (88 +/- 19) ml, P < 0.05] decreased synchronously. The ratio of end-systolic pressure to end-systolic volume [Psyst/ESV, (2.84 +/- 1.30) mmHg/ml vs (1.72 +/- 1.23) mmHg/ml, P < 0.05] increased significantly. Cardiac electromechanical mapping demonstrated significant improvement at three months after implantation of BMSCs compared with that pre-injection in both cardiac mechanical capability as left line local shorting [LLS, (11.29 +/- 1.64)% vs (7.32 +/- 1.86)%, P < 0.05] and electrical property as left ventricular endocardial unipolar voltage [UV, (10.38 +/- 1.12) mV vs (7.61 +/- 1.09) mV, P < 0.01]; perfusion defect decreased from (36.2 +/- 6.2)% to (20.3 +/- 5.31)% (P < 0.01). Twenty-four-hour electrocardiographic monitoring demonstrated no arrhythmias occurred at three-months follow-up.

CONCLUSIONSThe transplantation of BMSCs might improve the cardiac function and it is safe and feasible with no deaths or malignant arrhythmias.

Adult ; Aged ; Bone Marrow Cells ; cytology ; Female ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; cytology ; Middle Aged ; Myocardial Infarction ; therapy ; Tomography, Emission-Computed, Single-Photon ; Transplantation, Autologous